• Title/Summary/Keyword: Reconstruction timing

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Analysis of the Effects of Breast Reconstruction in Breast Cancer Patients Receiving Radiotherapy after Mastectomy

  • Kim, Seong-Hwan;Kim, Jeong-Min;Park, Sun-Hyung;Lee, Sam-Yong
    • Archives of Plastic Surgery
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    • v.39 no.3
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    • pp.222-226
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    • 2012
  • Background : Immediate breast reconstruction after mastectomy and delayed breast reconstruction with post-supplementary treatment are the two types of breast reconstruction currently performed when treating breast cancer. Post-mastectomy radiation therapy (PMRT) not only reduces local recurrence but also improves overall survival. However, the complications and survival rates associated with PMRT need to be clear when determining the timing of breast reconstruction. Accordingly, we investigated the optimal timing of breast reconstruction by observing patients who underwent mastectomy followed by PMRT, based on their overall health and aesthetic satisfaction. Methods : We retrospectively reviewed 21 patients who underwent breast reconstruction with PMRT between November 2004 and November 2010. We collected data regarding the various methods of mastectomy, and the modality of adjuvant therapy, such as chemotherapy, hormone therapy, and radiotherapy. Telephone interviews were conducted to study the general and aesthetic satisfaction. Results : Patients who received PMRT after breast reconstruction showed a greater complication rate than those undergoing breast reconstruction after PMRT (P=0.02). Aesthetic satisfaction was significantly higher in the groups undergoing breast reconstruction after PMRT (P=0.03). Patients who underwent breast reconstruction before PMRT developed complications more frequently, but they expressed greater aesthetic satisfaction with the treatment. Conclusions : It is recommended that the complication rates and aesthetic satisfaction after breast reconstruction be carefully considered when determining the optimal timing for radiotherapy.

Timing and Causes of Vascular Compromise in Breast Reconstruction with Free TRAM flap (복직근 유리 피판을 이용한 유방 재건에서 혈관성 이상 소견에 의한 재수술의 시점 및 원인)

  • Kim, Ji yeon;Chang, Hak;Minn, Kyung Won
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.555-558
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    • 2009
  • Purpose: The high success rate of free flap transfers is well documented in previous literature, and is possible due to the early detection of vascular compromise and timely reoperation. We specifically analyzed the operative results of immediate and delayed reconstruction with free transverse rectus abdominis musculocutaneous(TRAM) flap respectively in order to reveal its distinctive features on timing and causes of vascular compromise. Methods: The senior author operated on 158 patients, 161 cases of free TRAM flap for breast reconstruction. 51 patients underwent delayed reconstruction, whilst immediate reconstruction was performed in the other 107 patients. All patients were monitored every 3 hours for the first 3 days. We reviewed medical records of all patients, and tested statistical significance with the Fisher's test. Results: Reoperation was performed in 20 cases, but the cases include hematoma with bleeding focus and arterial anastomosis site rupture due to abrupt arm abduction. We performed reoperation in 15 cases of suspicious vascular compromise. Flap compromise was noticed mostly within 24 hours, but not longer than 72 hours. Venous compromise was dominant by 11 cases (73.3%). There was difference in the timing of flap compromise between immediate and delayed reconstruction. All the cases of delayed reconstruction did not show signs of vascular compromise after 12 hours postoperatively. On the other hand, cases of vascular compromise were observed until 72 hours postoperatively in cases of immediate reconstruction. Conclusion: Delayed reconstruction showed vascular compromise within 12 hours postoperatively, while immediate reconstruction showed compromised until the 3rd postoperative day. If more aggressive monitoring is maintained during this period, we believe salvage of flaps may be increased with more efficiency.

Performance evaluation of an adjustable gantry PET (AGPET) for small animal PET imaging

  • Song, Hankyeol;Kang, In Soo;Kim, Kyu Bom;Park, Chanwoo;Baek, Min Kyu;Lee, Seongyeon;Chung, Yong Hyun
    • Nuclear Engineering and Technology
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    • v.53 no.8
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    • pp.2646-2651
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    • 2021
  • A rectangular-shaped PET system with an adjustable gantry (AGPET) has been developed for imaging small animals. The AGPET system employs a new depth of interaction (DOI) method using a depth dependent reflector patterns and a new digital time pickoff method based on the pulse reconstruction method. To evaluate the performance of the AGPET, timing resolution, intrinsic spatial resolution and point source images were acquired. The timing resolution and intrinsic spatial resolution were measured using two detector modules and Na-22 gamma source. The PET images were acquired in two field of view (FOV) sizes, 30 mm and 90 mm, to demonstrate the characteristic of the AGPET. As a result of in the experiment results, the timing resolution was 0.9 ns using the pulse reconstruction method based on the bi-exponential model. The intrinsic spatial resolution was an average of 1.7 mm and the spatial resolution of PET images after DOI correction was 2.08 mm and 2.25 mm at the centers of 30 mm and 90 mm FOV, respectively. The results show that the proposed AGPET system provided higher sensitivity and resolution for small animal imaging.

Optimal Cardiac Magnetic Resonance Contrast-Enhanced Timing Robust Angiography (CMR-CENTRA) for the Three-Dimensional Reconstruction of the Bilateral Atria in the Electroanatomic Mapping (EAM) of Atrial Fibrillation

  • Kim, Jun Seong;Oh, Yu-Whan;Shim, Jaemin;Kim, Young-Hoon;Hwang, Sung Ho
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.3
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    • pp.131-138
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    • 2017
  • Purpose: To optimize the timing of scans using cardiac magnetic resonance contrast-enhanced timing robust angiography (CMR-CENTRA) for electroanatomic mapping (EAM) of the right atrium (RA) and left atrium (LA) in patients with atrial fibrillation (AF). Materials and Methods: Fifty patients with AF (38 men; mean age, $59.6{\pm}9.3years$) underwent CMR-CENTRA in preparation for EAM. The CMR-CENTRA data were acquired at five different scan times: 0 seconds, 5 seconds, 10 seconds, 15 seconds, and 20 seconds after an intravenous injection of contrast media. To evaluate the degree of contrast enhancement, right atrial relative contrast (RA-RC) and left atrial relative contrast (LA-RC) on the CMR-CENTRA scans were assessed at each time point. The three-dimensional (3D) reconstruction of the RA and LA for the EAM system was performed using the CMR-CENTRA data. Results: A CMR-CENTRA at a scan time of 10 seconds showed significantly greater LA-RC (P < 0.05) compared with all other scan times. A CMR-CENTRA at a scan time of 15 seconds showed significantly greater RA-RC (P < 0.05) compared with all other scan times. In the 3D reconstruction of the RA, the success rates of CMR-CENTRA at scan times of 10 seconds and 15 seconds were 18% and 100%, respectively. In the 3D reconstruction of the LA, the success rates of CMR-CENTRA at 10- and 15-second scan times were 100%. Conclusion: The CMR-CENTRA data acquired at 15 seconds after the injection of contrast media is appropriate for the preparation of an EAM system that is focused on the RA and LA in patients with AF.

TELEMETRY TIMING ANALYSIS FOR IMAGE RECONSTRUCTION OF KOMPSAT SPACECRAFT

  • Lee, Jin-Ho;Chang, Young-Keun
    • Journal of Astronomy and Space Sciences
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    • v.17 no.1
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    • pp.117-122
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    • 2000
  • The KOMPSAT(Korea Multi-Purpose SATellite) has two optical imaging instruments called EOC(Electro-Optical Camera) and OSMI (Ocean Scanning Multispectral Imager). The image data of these instruments are transmitted to ground station and restored correctly after post-processing with the telemetry data transfeered from KOMPSAT spacecraft. The major timing information of the KOMPSAT is OBT (On-Board Time) which is formatted by the on-board computer of the spacecraft, based on 1Hz sync. pulse coming from the GPS receiver involved. The OBT is transmitted to ground station with the house-keeping telemetry data of the spacecraft while it is distributed to the instruments via 1553B data bus for synchronization during imaging and formatting. The timing information contained in the spacecraft telemetry data would have direct relation to the image data of the instruments, which should be well explained to get a more accurate image. This paper addresses the timing analysis of the KOMPSAT spacecraft and instruments, including the gyro data timing analysis for the correct restoration of the EOC and OSMI image data at ground station.

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Complications of Anterior Cruciate Ligament Reconstruction (전방십자인대 재건술의 합병증)

  • Song Eun-Kyoo;Kim Jong-Seok
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.1
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    • pp.15-19
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    • 2003
  • Although the number of anterior cruciate ligament reconstruction is increasing, complications after primary ACL reconstruction are more difficult to determine. Intraoperative and postoperative complications can lead to ultimate failure of a primary reconstructive procedure. Therefore, surgical success in ACL reconstruction requires detailed knowledge and technical advancements about ACL reconstruction. Preoperatively surgeon must pay attention to selection of grafts and methods of fixation, and intraoperatively, attention to the harvest of graft, passage of graft, intraarticuar placement of the graft, notchplasty, proper tensioning of the graft, and others. Postoperative complications must be detected early, including infection, abnormal healing responses, arthrofibrosis, graft rejection, and reflex sympathetic dystrophy. Careful patient selection, appropriate surgical timing, careful surgical technique, and supervised preoperative and postoperative rehabilitation can minimize postoperative complications.

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A NOVEL PARALLEL METHOD FOR SPECKLE MASKING RECONSTRUCTION USING THE OPENMP

  • LI, XUEBAO;ZHENG, YANFANG
    • Journal of The Korean Astronomical Society
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    • v.49 no.4
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    • pp.157-162
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    • 2016
  • High resolution reconstruction technology is developed to help enhance the spatial resolution of observational images for ground-based solar telescopes, such as speckle masking. Near real-time reconstruction performance is achieved on a high performance cluster using the Message Passing Interface (MPI). However, much time is spent in reconstructing solar subimages in such a speckle reconstruction. We design and implement a novel parallel method for speckle masking reconstruction of solar subimage on a shared memory machine using the OpenMP. Real tests are performed to verify the correctness of our codes. We present the details of several parallel reconstruction steps. The parallel implementation between various modules shows a great speed increase as compared to single thread serial implementation, and a speedup of about 2.5 is achieved in one subimage reconstruction. The timing result for reconstructing one subimage with 256×256 pixels shows a clear advantage with greater number of threads. This novel parallel method can be valuable in real-time reconstruction of solar images, especially after porting to a high performance cluster.

A comparison of delayed versus immediate reconstruction following lower-extremity sarcoma resection

  • Zhou, Sarah;Azzi, Alain J;Safran, Tyler;Zadeh, Teanoosh
    • Archives of Plastic Surgery
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    • v.47 no.1
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    • pp.49-53
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    • 2020
  • Background Identifying patients who may be at high risk for wound complications postsarcoma resection and reconstruction is essential for improving functional outcomes and quality of life. Currently, the effect of timing on sarcoma reconstruction has been poorly investigated. The purpose of this study was to compare outcomes of delayed and immediate reconstruction in the setting of sarcoma resection requiring flap reconstruction in the lower extremity. Methods A retrospective review of the senior author's sarcoma reconstruction patients from January 2005 to July 2017 was completed. All patients undergoing flap reconstruction of the lower extremity were included. Complications in the early postoperative period were compared between delayed and immediate reconstructive procedures. Results A total of 32 patients (7 delayed, 25 immediate) were included in this study. There was a significantly increased rate of overall complications (100% vs. 28.0%, P=0.001) and rate of hematomas (28.6% vs. 0.0%, P=0.042) in the delayed reconstruction group. Other complications including dehiscence, seroma, infection, venous thrombosis, and total/partial flap loss were also increased in the delayed reconstruction group, but this was not considered to be significant. Conclusions This study suggests that delayed reconstruction following sarcoma resection of the lower extremity had a higher incidence of overall complications and hematoma formation. We emphasize the importance of early plastic and reconstructive surgeon referral and the necessity to closely monitor delayed reconstruction patients for complications.

Evidence-Based Physical Therapy for Anterior Cruciate Ligament Injury: Literature Review

  • Lim, Hyoung won
    • The Journal of Korean Physical Therapy
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    • v.31 no.4
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    • pp.161-168
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    • 2019
  • Most athletes with anterior cruciate ligament (ACL) ruptures undergo a surgical ACL reconstruction (ACLR) and rehabilitation. On the other hand, controversy still exists because neither a reconstruction nor rehabilitation have been proven to be superior in the management of ACL injury. This study reviewed the success rates of interventions to provide recommendations for the optimal management after an ACL injury. One of the most important considerations after an ACL injury is the timing and type of intervention. At the early stages, which involve the loss of volume and strength of quadriceps femoral muscle, weight bearing (closed kinetic chain) exercises with pain management followed by high velocity resistance exercises in an open kinetic chain environment are recommended to improve the quadriceps function. After that, it is important to apply intensive isokinetic exercise with a lower extension rate. In this case, it is important to apply overload to the muscles and to simultaneously lead the co-contraction of the hamstrings. Standards are essential because the timing and type of interventions are crucial to prevent re-injury and complications, such as osteoarthritis, as well as to confirm the successful outcome of the treatment. Different interventions recommended for ACL damage have yet to reach consensus. Further studies will be needed to observe the effects of the intervention through multidisciplinary approaches.

Breast Reconstruction with Lower Abdominal Tissue Free Transfer (하복부 조직 유리피판에 의한 유방재건술)

  • Ahn, Hee-Chang
    • Archives of Reconstructive Microsurgery
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    • v.19 no.1
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    • pp.68-79
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    • 2010
  • Lower abdominal tissue is regarded as an ideal donor site for the breast reconstruction because it provides large skin territory and huge amount of soft tissues enough to the breast size. However it is not easy for the surgeon to reconstruct the really natural breast, and needs the learning curve with long time experience. Author represent the various reconstruction procedures for the breast using lower abdominal tissue such as muscle sparing free TRAM, DIEP, and SIEA free flaps to reinsure like breast. Indications, and selection of reconstructive methods, surgical timing, selection of donor sites and recipient vessel of these flaps were reviewed. In addition, detailed procedures, surgical tips and secondary adjuvant procedures are described for more symmetry of reconstructed breast. The muscle sparing free TRAM, DIEP, and SIEA free flaps would be enough to provide supple, huge amount of well vascularized tissue for the breast, if these flaps were selected for the appropriate indication according to patient's general condition, obesity, the opposite breast and abdominal tissue condition. Lower abdominal tissue was able to provide versatile designs with sufficient adipose tissue without compromising the integrity of abdominal wall.

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